Efforts to reduce cardiovascular disease working

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In 2009, it was announced that cardiovascular disease is no longer the leading cause of death in San Diego County. During the past five years, there has been a 13 percent decrease in the number of deaths caused by cardiovascular disease in San Diego County, and a staggering 26 percent drop in the number of lives claimed by stroke in the county.

The American Heart Association is excited about this turn of events, as it reinforces the important and successful role the association plays in reducing death and disability from cardiovascular disease. This landmark achievement came about as a result of tremendous efforts from many partners across the community, including research, health care, government and business. Not to mention individual choices we all make.

Multiple factors appear to have led to the reduction in deaths. Ongoing scientific research has led to improvements in medications and in technology. The development of evidence-based practice guidelines has helped health care providers know what is effective both for the treatment and prevention of heart attacks and strokes. Some of the advances are complex and others are quite simple, though important.

We know that getting patients to the hospital quickly for the appropriate treatment is crucial to saving lives. We know that timely angioplasty to open blocked coronary arteries, or thrombolysis when primary angioplasty is not available or appropriate, is making a difference.

We also know that improving the quality of care through the dissemination of evidence-based clinical guidelines can help patients benefit from the research that we and others have supported, helping them live longer and reducing their risk of a second heart attack or stroke. The American Heart Association's Get With The Guidelines hospital-based quality improvement program initiative is just one way the American Heart Association continues to translate scientific knowledge into day-to-day practice.

Among those practice measures making a difference is better control of blood pressure and cholesterol levels, both with lifestyle change and with medications. Cause campaigns such as Start!, Go Red For Women and Power to End Stroke are making a difference right here in San Diego. In addition, a variety of strategies at the local, state and federal level to reduce smoking are working, including tobacco excise taxes, clean indoor air legislation and smoking cessation efforts.

As encouraging as this news is, heart disease and stroke remain the No. 1 and No. 3 causes of death in the United States. All of the major risk factors for these leading causes of death are still too high, and several are actually on the rise. If this trend continues, the victory both locally and nationally could be short-lived if the risk factors that lead to heart disease and stroke are not also reduced.

We are working to address these risk factors, in particular hypertension, high blood cholesterol, obesity, diabetes, physical inactivity and tobacco use. Because of progress in research, each of these risk factors can be controlled to goal levels for nearly everyone with either lifestyle changes alone or lifestyle changes combined with modern medication.

We also are continuing to push for more research and new medical advances, along with improved adherence to our practice guidelines. Most importantly, we are working to help companies and individuals prioritize lifestyle and behavior changes, while at the same time stressing the patient-health care provider partnership that can control risk factors and reduce the risk of developing cardiovascular disease in the first place.
We will remain diligent in these efforts to ensure that they continue to pay dividends, both nationally and right here in San Diego.

Dunford, M.D., is an American Heart Association volunteer and San Diego Division board president.